To the Editor.—Family physicians had anticipated that the changes created by physician payment reform would provide some relief from the ever-shrinking reimbursements to their specialty from the Medicare system. Indeed, family physicians were designated the "big winners," with estimates of a 16% increase in payments in 1992.1 These changes were needed to establish more equitable reimbursements for services. It was also hoped that payment reform could reverse the negative attitudes held by many family physicians toward the Medicare program.2 A 1991 survey by the North Carolina Academy of Family Physicians (unpublished data) showed that nearly half of North Carolina family physicians were limiting their Medicare practices, and many more considered doing so in light of continued Medicare cuts.Many other specialists criticized family physicians for supporting the "Robin Hood" Medicare reforms. Although some looked on physician payment reform as stealing from the rich and giving to